menieres disease

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Author:
alvo2234
ID:
270239
Filename:
menieres disease
Updated:
2014-04-12 18:50:33
Tags:
pt VII
Folders:
exam III
Description:
dr leonard
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  1. the three major sx of menieres
    • vertigo
    • deafness
    • tinnitus
  2. what are other sx of menieres other than the 3 major sx
    aural fulness
  3. causes of menieres disease
    • multifactorial
    • problems with endolymph (concen/amt)
    • improper fluid drainage
    • abnormal immune response
    • allergies
    • viral infection
    • genetic disposition
    • head trauma
  4. what does a dx of menieres disease require
    two spontaneous episodes of vertigo each lasting 20 min

    hearing loss verified by hearing test at least one occasion

    tinnitus or aural fullness

    R/O
  5. what is the AAO-HNS objective outcome of menieres therapy
    control of vertigo
  6. what is a Class A complete control of vertigo
    CoV=0
  7. what is Class B substanial control of vertigo
    CoV 1 - 40
  8. what are the two types of treatment for menieres disease
    modulate/reduce severity and frequency of attacks

    target single symptom (usually vertigo) by ablating vestibular end organ
  9. what is the purpose of modifying your diet in menieres disease
    to reduce fluid retension and help decrease fluid in the ear
  10. what are some of the dietary changes that can take place
    • eat regularly
    • limit salt (aim for 1500mg or less/day)
    • avoid MSG
  11. what are some medications used during an episode of vertigo
    meclizine (antivert) or diazepam (valium) may reduce spinning sensation of vertigo and help control n/v

    promethazine for N/V
  12. what are some of the long term medications used for menieres
    diuretic (reduce fluid retension)
  13. what are the noninvasive therapies and procedures used to treat menieres
    • vestibular rehab (exercise and activites)
    • hearing aid
    • meniett device (positive pressure to inner ear to improve fluid exchange)
  14. middle ear injections for menieres disease
    • gentamicin
    • steroids
  15. what is the risk of gentamicin inner ear injections
    further hearing loss
  16. which inner ear injection is less likely to cause hearing loss
    steroid injection
  17. surgical procedures used to treat menieres
    • endoplymphatic sac procedures
    • vestibular nerve section
    • labrinthectomy
  18. what role does the endolymphatic sac play in the ear
    regulates inner ear fluid levels by inc/dec fluid production and absorption
  19. what is endolymphatic sac decompression
    a small portion of bone is remove from over the endolymphatic sac and sometimes this procedure is coupled with the placement of a shunt to drain excess fluid from your inner ear.
  20. what is a vestibular nerve section
    cutting the nerve that connects balance and movement sensors in your inner ear to the brain (corrects vertigo)
  21. what is a labrinthectomy
    removal of a portion or all of the inner ear, thereby removing both balance and hearing function from the affected ear
  22. what is labrinthectomy performed
    when the pt has near total or total hearing loss
  23. other lifestyle changes for menieres diesease
    • avoid caffeine
    • stop smoking
    • manage stress and anxiety
    • avoid allergens
  24. what percent does bilateral vestibulopathy account for all dizziness
    1%
  25. what is bilateral vestibulopathy often due to
    exposure to an ototoxic medication (50%)
  26. what is the single most known cause of bilateral vestibulopathy
    gentamicin (15-50%)

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